NewMedical Scribe Oak Street HealthMedical ScribeDayton, OH$17–$28.46Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Coding Rep I Cincinnati Children's Hospital Medical CenterCoding Rep ICincinnati, OHRemote$22.18–$27.73 / hourCertification/credentialed as Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT) OR Registered Health Information Admin (RHIA) OR Certified Professional Coder (CPC) Certified Coding Associate (CCA) Certified professional Coder Apprentice (CPC-A) Certified Coding Specialist -Physician (CCS-P) OR Eligible to sit for credentials exam. Coding - Reviews and screens the medical record to abstract designated statistical and clinical data and enters reliable information into Epic, and/or Fastrack, as appropriate.
Coding Rep II Cincinnati Children's Hospital Medical CenterCoding Rep IICincinnati, OHRemote$25.82–$32.28 / hourCertification/credentialed as Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT), or Registered Health Info Admin (RHIA) OR Certified Professional Coder (CPC) OR Certified professional Coder Apprentice (CPC-A) OR Certified Coding Specialist -Physician (CCS-P). Assigns ICD-10-CM and/or CPT codes to accounts in an accurate and ethical manner utilizing 3M encoding software and coding manuals.
NewPI Medical Coding Reviewer II (CPC, RHIT or RHIA required) CareSourcePI Medical Coding Reviewer II (CPC, RHIT or RHIA required)Dayton, OH$54,500–$87,300 / yearJob Summary: The Program Integrity Medical Coding Reviewer II is responsible for review of medical record audit activities, dispute support as needed, medical records work queues as well as claim reviews for provider pre-payment and post-payment functions. CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.
Coder II, PBO Coding, Physician Coding for Emergency Dept, Full Time, First Shift UC HealthCoder II, PBO Coding, Physician Coding for Emergency Dept, Full Time, First ShiftCincinnati, OHThe Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing.
Coding and Billing Supervisor - Corporate Health TriHealth IncCoding and Billing Supervisor - Corporate HealthOHTriHealth leaders create a culture of engagement, safety & reliability and high performance by consistently modeling and utilizing the following TriHealth Way leadership competencies, tactics and ALWAYS Behaviors to drive strategic pillar results: Achievement of Annual Pillar Goals: 1) Safety/Quality, 2) Service, 3) Growth, 4) Culture/People, 5) Finance. Job Overview: Under the guidance of the Finance and Administrative Services Manager in Corporate Health, the Supervisor of Billing and Coding - Corporate Health will provide hands-on leadership and oversight of daily billing/coding operations within Corporate Health.
BILLING & CODING COMPLIANCE ANALYST Premier Health PartnersBILLING & CODING COMPLIANCE ANALYSTDayton, OHCCS - Certified Coding Specialist An AHIMA credential for advanced-level coders skilled in inpatient and outpatient coding, data quality, and DRG assignment. Definitions: RHIA - Registered Health Information Administrator A credential from AHIMA for professionals who manage health information systems, ensure data integrity, oversee compliance with privacy laws, and often hold leadership roles in HIM departments.
Medical Coding Appeals Analyst Elevance Health IncMedical Coding Appeals AnalystMason, OHWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Professional Coding Fee Analyst Dayton Children's HospitalProfessional Coding Fee AnalystOHJob Details: Ensures the accuracy, efficiency, and maximum financial return of Dayton Children''s professional billing claims for reimbursement. Ensures billing compliance; maintains knowledge of CPT and ICD-10 coding guidelines, as well as Medicare/Medicaid billing rules and regulations.
Coding Specialist II TriHealth IncCoding Specialist IINorwood, OHJob Overview: This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. In this position, you'll review provider documentation, assign correct ICD and CPT codes, research denials, and collaborate with clinical teams to ensure clarity and consistency in documentation and coding practices.
TCHP Coding Educator The Christ HospitalTCHP Coding EducatorNorwood, OHDemonstrated ability to effectively work within a team environment, using excellent written, verbal, and presentation skills to share audit findings, risk areas, and compliance issues with coders, office managers, physicians, etc. Educate and support physicians and PB coders in accurate, complete, and compliant clinical documentation and coding practices by interpreting patient medical records, provide targeted feedback, and promote adherence to regulatory guidelines resulting in appropriate reimbursement.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Cincinnati, OHIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Coder II, PBO Coding, Full Time, First Shift UC Health, LLCCoder II, PBO Coding, Full Time, First ShiftCincinnati, OHFull timeThe Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing.
Coder II, Corporate Coding, Full Time, First Shift UC HealthCoder II, Corporate Coding, Full Time, First ShiftCincinnati, OHThe Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing.
TCHP Coding Educator The Christ Hospital Health NetworkTCHP Coding EducatorNorwood, OHDemonstrated ability to effectively work within a team environment, using excellent written, verbal, and presentation skills to share audit findings, risk areas, and compliance issues with coders, office managers, physicians, etc. Educate and support physicians and PB coders in accurate, complete, and compliant clinical documentation and coding practices by interpreting patient medical records, provide targeted feedback, and promote adherence to regulatory guidelines resulting in appropriate reimbursement.
Lead Coding Specialist TriHealth IncLead Coding SpecialistNorwood, OHIncentives & Benefits: In addition to a comprehensive benefits package - including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement - this role offers competitive shift differentials, with the opportunity to earn up to an additional $7 per hour based on shift, hours worked, and organizational guidelines. TriHealth invests in your growth with ongoing training, coding guideline updates, and leadership support, ensuring you have the tools and resources to excel as a subject matter expert.
Managed Services - Revenue Cycle Coding - Senior Manager PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior ManagerOH$124,000–$280,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. As a Senior Manager, you will leverage your skills and influence to deliver quality results, motivate and coach teams to solve complex problems, and apply sound judgment to recognize when to take action or escalate issues.
NewRemote Inpatient Coding Specialist - Career Growth UASIRemote Inpatient Coding Specialist - Career GrowthCincinnati, OHRemoteUASI provides a supportive workplace recognized as a Top Workplace by the Cincinnati Enquirer, offering competitive salaries, full benefits, and career growth opportunities.#J-18808-Ljbffr. UASI is looking for an Inpatient Coding Specialist to join their award-winning team in Cincinnati, Ohio.
Medical Billing Assistant - Entry Level VitalsearchgroupMedical Billing Assistant - Entry LevelCincinnati, OhioThe Medical Billing Assistant will help prepare and review insurance claims, assist with basic billing and coding tasks, update patient and insurance information, and support the administrative workflows that help keep clinical operations running smoothly. This person should be comfortable learning billing and coding processes, communicating with patients professionally, and maintaining accuracy when working with claims, records, and confidential information.
NewMedical Billing Specialist Equitas Health, Inc.Medical Billing SpecialistDayton, OH$23.56–$32.98 / hourPart timeWith 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives. This encompasses going beyond giving and receiving instructions and includes but is not limited to (a) performing work activities requiring interacting or speaking with others, and (b) responding appropriately to constructive feedback or suggestions for improvement from a supervisor.
NewMedical Billing Specialist Equitas HealthMedical Billing SpecialistDayton, OhioWith 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives. This encompasses going beyond giving and receiving instructions and includes but is not limited to (a) performing work activities requiring interacting or speaking with others, and (b) responding appropriately to constructive feedback or suggestions for improvement from a supervisor.
LEAD MEDICAL BILLING SPEC-REMOTE Premier Health PartnersLEAD MEDICAL BILLING SPEC-REMOTEOHRemoteEnsure Team Members are completing tasks/job functions timely • Coders receive charges from centers • Coders code charges within 1 day/24 hours of receipt of charge from centers • Coded charges/charge slips to Charge Entry team same day as coding completed • Charge Review team defers any charge not accepted with notes indicating why the charge is deferred b. Faxes, mail, and courier items distributed immediately (utilizing mail boxes at front door rather than interrupting staff at work stations) • Charges received via fax are batched using a Batch cover sheet • Batch is logged into the Extraction Log on the CBO Shred Drive • Batch is delivered to the correct coding staff member's mailbox b.
SUPERVISOR: MEDICAL BILLING Premier Health PartnersSUPERVISOR: MEDICAL BILLINGOHAn effective Senior Team Lead will provide guidance to their team based on management direction, will use their experience and knowledge of the tools the team uses (e.g., EPIC), policies, and guidelines to educate team members, will identify areas for improvement systematically and within their team, and will communicate directly with management the status of resolved and outstanding issues/roadblocks within the team. A Team Lead should actively seek and seize opportunities for improvement, should be willing to take on additional responsibilities, assignments, and projects when needed, should be committed to organizational goals and be willing to put forth extra effort to reach organizational goals.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorOH$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Medical Billing Manager Dayton Center for Neurological DisordersMedical Billing ManagerCenterville, OhioEducation/Experience: Required: High School diploma and 5 years of Medical Office Billing experience Preferred: Degree or Certificate in Medical Office Billing Required: Billing/Coding Certification (Preferred Certifications: CPC, CPB,CPMA, CPCO) Language Ability: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Certificates and Licenses: Valid Driver's License Equipment: Multi-line telephone Facsimile machine Copier Postage meter Calculator Computer Printer Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistOH$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Revenue Cycle Manager UC HealthRevenue Cycle ManagerCincinnati, OHJoin our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
Patient Financial Advocate Firstsource Solutions LtdPatient Financial AdvocateCincinnati, OHThe Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
NewTeam Lead, Program Integrity (Triage) CareSourceTeam Lead, Program Integrity (Triage)Dayton, OH$72,200–$115,500 / yearCareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. Job Summary: The Team Lead, Program Integrity drives and encourages innovative investigative processes and workflows to reduce turnaround time and produce positive investigative outcomes.
NewA/R Billing Specialist NECCOA/R Billing SpecialistCincinnati, OH$30–$45 / hourClaims Management Utilize the Electronic Health Record (EHR) system to generate claims for per diem and fee-for-service billing and submit invoices to payorsReview and take action on submitted claims within 30–45 days to ensure timely resolutionMonitor, investigate, and resolve held, rejected, or denied claims using EHR and clearinghouse toolsAssist with cash application processes, including reconciliation of open accounts receivable balancesMaintain accurate documentation related to billing activities and claim outcomesCustomer Service Foster strong internal and external relationships to support timely resolution of billing discrepanciesCommunicate effectively with payors, service line teams, and leadership regarding claim status and issuesIdentify and recommend opportunities for process and policy improvement based on trends observed during collections and claim follow-up. Position Summary The Claims Management Specialist is responsible for managing the billing and claims lifecycle to ensure accurate claim submission, timely reimbursement, regulatory compliance, and effective collaboration with internal and external stakeholders.
BILLING QA COMPLIANCE SPEC Premier Health PartnersBILLING QA COMPLIANCE SPECOHGeneral Summary/Responsibilities: Under the general direction of the Supervisor Patient Financial Services this employee is responsible for the review of Inpatient and Outpatient accounts for billing and coding compliance for Patient Financial Services (PFS). The specialist is also responsible for understanding reimbursement aspects of the revenue cycle and will work to ensure Premier Health receives the appropriate reimbursement for charges billed.
NewA/R Billing Specialist NECCO (ED Necco & Associates Inc.)A/R Billing SpecialistCincinnati, OH$30–$45 / hourThe candidate selected will be responsible for the following:Claims ManagementUtilize the Electronic Health Record (EHR) system to generate claims for per diem and fee‑for‑service billing and submit invoices to payorsReview and take action on submitted claims within 30–45 days to ensure timely resolutionMonitor, investigate, and resolve held, rejected, or denied claims using EHR and clearinghouse toolsAssist with cash application processes, including reconciliation of open accounts receivable balancesMaintain accurate documentation related to billing activities and claim outcomesCustomer ServiceFoster strong internal and external relationships to support timely resolution of billing discrepanciesCommunicate effectively with payors, service line teams, and leadership regarding claim status and issuesIdentify and recommend opportunities for process and policy improvement based on trends observed during collections and claim follow‑up. Corp - Cincinnati1404 Race Street STE 302Cincinnati, OH 45202, USAThe Claims Management Specialist is responsible for managing the billing and claims lifecycle to ensure accurate claim submission, timely reimbursement, regulatory compliance, and effective collaboration with internal and external stakeholders.
MEDICAL BILLING SPECIALIST II- Premier Health PartnersMEDICAL BILLING SPECIALIST II-OHThe Medical Billing Specialist works to ensure timely and accurate reimbursement on medical claims for physician services rendered. This position will submit claims utilizing insurance carrier guidelines and will also follow up on submitted claims that are unpaid, rejected, or denied.
Director of Revenue Cycle Management The Healthcare ConneDirector of Revenue Cycle ManagementCincinnati, OhioRemoteCareer Opportunity : Director of Revenue Cycle Management Reports to: Chief Financial Officer Organization : The HealthCare Connection (THCC) Location : Cincinnati, OH - Lincoln Heights (Remote Position) About The HealthCare Connection : Founded in 1967, The HealthCare Connection was Ohio’s first Federally Qualified Health Center (FQHC). The Director collaborates closely with clinical, operational, finance, and third-party billing teams to ensure compliant, efficient, and financially sustainable revenue cycle operations that support access to high-quality patient care.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorOH$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
A/R Billing Specialist Carvaka, LLCA/R Billing SpecialistCincinnati, OHPart timeThe Claims Management Specialist is responsible for managing the billing and claims lifecycle to ensure accurate claim submission, timely reimbursement, regulatory compliance, and effective collaboration with internal and external stakeholders. We believe that a diverse team fosters innovation and creativity, and we actively seek candidates from all races, ethnicities, religions, genders, sexual orientations, abilities, and ages to join our organization.
Director of Revenue Cycle Management HEALTHCARE CONNECTION, INC.,THEDirector of Revenue Cycle ManagementCincinnati, OHThe Director collaborates closely with clinical, operational, finance, and third-party billing teams to ensure compliant, efficient, and financially sustainable revenue cycle operations that support access to high-quality patient care. Key Responsibilities: Direct and oversee all revenue cycle operations including registration, charge capture, coding, billing, claims processing, payment posting, denial management, collections, and reimbursement analysis.
NewClaims Management & AR Billing Specialist Revenue Cycle Pro NECCOClaims Management & AR Billing Specialist Revenue Cycle ProCincinnati, OHNecco is seeking a Claims Management Specialist in Cincinnati, Ohio, responsible for overseeing the billing and claims lifecycle. The ideal candidate will have a background in medical billing/coding and at least 3 years of experience, ensuring timely claim submissions and compliance with regulations.
Executive Case Manager (Remote) ValerisExecutive Case Manager (Remote)Cincinnati, OhioRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Personalized Case Management Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine.
A/R Billing Specialist ENA IncA/R Billing SpecialistCincinnati, OHPosition Summary: The Claims Management Specialist is responsible for managing the billing and claims lifecycle to ensure accurate claim submission, timely reimbursement, regulatory compliance, and effective collaboration with internal and external stakeholders. We believe that a diverse team fosters innovation and creativity, and we actively seek candidates from all races, ethnicities, religions, genders, sexual orientations, abilities, and ages to join our organization.
Trauma Data Specialist I, Full Time, First UC HealthTrauma Data Specialist I, Full Time, FirstCincinnati, OHCompletes a variety of Trauma, Burn, and Acute Care Surgery Registry tasks, including data collection, data entry and retrieval, data quality and integrity, data analysis, and display and statistical conversion for the purpose of research, performance improvement, injury prevention, education, billing, and outcome measurements. Obtains, abstracts, and enters all appropriate patient-related information into the appropriate databases in an accurate and timely manner by: Obtaining information by monitoring daily trauma patient admissions, transfers, and discharges, and confirming all patients and patient changes on the registry, autopsy, and patient identification logs.
Licensed Practical Nurse/Medical Home Coordinator TriHealth IncLicensed Practical Nurse/Medical Home CoordinatorOHJob Overview: This position provides both direct and indirect patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Documents all aspects of care accurately, including clinical calls, rooming questions, procedures, orders, prescriptions, pharmacy coordination, and workflow tasks; manages MyChart and patient messages in a timely manner.
Medical Assistant TriHealth IncMedical AssistantCincinnati, OHJob Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
Medical Assistant - Pediatrics - Western Hills TriHealth IncMedical Assistant - Pediatrics - Western HillsOHJob Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow-up. Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
NewMedical Assistant- Kenwood Internal Medicine TriHealth IncMedical Assistant- Kenwood Internal MedicineCincinnati, OHJob Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
NewLicensed Practical Nurse or Medical Assistant TriHealth IncLicensed Practical Nurse or Medical AssistantWilmington, OHJob Overview: This position provides both direct and indirect patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Documents all aspects of care accurately, including clinical calls, rooming questions, procedures, orders, prescriptions, pharmacy coordination, and workflow tasks; manages MyChart and patient messages in a timely manner.
Prior Authorization Specialist Riverhills NeurosciencePrior Authorization SpecialistCincinnati, OHFull timeSuperior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors. Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
Patient Account Representative Dayton Center for Neurological DisordersPatient Account RepresentativeCenterville, OhioThis person will communicate with patients, and coworkers, and practice leadership by answering a busy telephone queue, emails, chat messages, and TEAMs messages to assist with any questions regarding balances, billing, collections and reimbursement. The primary function of this position will be to be the main point of contact for patients that are calling in to the practice to discuss their balances, collect payments over the phone, set up payment plans, etc.
Director, Pharmacy Clinical Strategy(Preferred Experience in Medical Drug Management Strategy) CareSourceDirector, Pharmacy Clinical Strategy(Preferred Experience in Medical Drug Management Strategy)Dayton, OH$135,600–$237,400 / yearJob Summary: The Director, Pharmacy Clinical Strategy leads the strategic development of formulary management best practices & industry-leading, market-competitive formulary and medical drug strategies across all CareSource lines of business and markets. Essential Functions: Ensures the efficient operational management of the formulary and medical drug management and clinical policy/criteria development teams with emphasis on execution, outcomes, continual improvement and performance enhancement.
Billing Associate Specialist Ensemble Health PartnersBilling Associate SpecialistCincinnati, OH$17–$18.65 / hourCollaborate closely with Billing and Denials Management to identify trends, recommend new claim rules and edits, and support compliant billing practices, in addition to monitoring electronic claim transfers and helping manage unbilled accounts across all systems. Works daily electronic 277s, RTPs, failed bills, late charges, rebills, and failed claims within host systems and billing vendors, while also processing hardcopy claims and attaching required documentation such as EOBs and medical records.